# The General Factor of Psychopathology in Psychosis and Severe Mental Illness

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $913,520

## Abstract

An increasing body of evidence on the structure of psychopathology indicates the presence of a general factor
of psychopathology (GF), also referred to as a P-factor, that explains a significant amount of the common
variance in the expression of multiple psychopathological symptoms and disorders. The presence of a GF has
substantial implications for understanding psychopathology because it suggests that a comprehensive
understanding of mental illness requires an untangling of nonspecific risk factors from more narrow, dimension-
specific risk factors or features. Caspi et al., (2014) suggest that schizophrenia symptoms are so highly correlated with the GF, that they are mostly an expression of the GF. However, methodological limitations, such as the use of community and youth samples, limit conclusions from the existing literature. We propose to test the hypothesis that schizophrenia spectrum (SS) symptoms load heavily on both a GF AND a separate higher-order psychosis factor using a sample of 1000 adult psychiatric and medical treatment seeking subjects that includes a substantial group of
patients with SS disorders as well as patients with significant externalizing and internalizing symptoms. The
potential utility of this hierarchical dimensional approach is that it allows quantification of the extent to which
each individual possesses a high GF score (reflected in the overall breadth of symptoms), or symptoms that are
more narrowly constrained to a specific 2nd order factor (such as externalizing, internalizing, and psychosis
factors) or even more narrow, first-order symptom dimensions. Using this quantitative approach, we will test the
extent to which neuropsychological and structural and functional MRI measures that have previously been
observed in patients with schizophrenia are more strongly related to the GF versus a psychosis factor. This will
allow us to test the hypothesis that some neural correlates, such as the volume of the anterior cingulate area,
are nonspecific correlates of the GF, while others, such as temporal cortical sensory processing abnormalities,
are specific to the psychosis, and remain even after controlling for the GF. In order to test the prognostic
significance of the GF, we will additionally test whether scores on the GF are predictive of course of illness in 50
SS patients experiencing first-episode psychosis. Taken together, the study will provide the most
comprehensive test to date of the relevance of GF model to understanding the expression and neural correlates
of severe psychopathology,

## Key facts

- **NIH application ID:** 10413229
- **Project number:** 5R01MH118273-04
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** STEPHAN HECKERS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $913,520
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413229

## Citation

> US National Institutes of Health, RePORTER application 10413229, The General Factor of Psychopathology in Psychosis and Severe Mental Illness (5R01MH118273-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10413229. Licensed CC0.

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